| Abstract |
Abstract：Objective To investigate whether esketamine can improve depression after cesarean section, reduce pain after obstetrics and gynecology, and promote rapid recovery of parturients. Methods There were 91 women undergoing cesarean section under neuraxial anesthesia, divided into esketamine group (ES group) and control group (D group), 45 cases in ES group and 46 cases in D group.All surgical patients are given PCIA at the end of surgery. ES group: es-ketamine 0.5mg/kg + butorphanol 0.1mg/kg + palonosetron 0.25mg + normal saline diluted into 100ml; Group D: Butorphanol 0.15mg/kg + Palonoseron 0.25mg + normal saline diluted to 100ml. The analgesia pump parameters were set to be consistent between the two groups (infusion volume of 2 ml/h). The VAS pain scores of resting, exercise, and contraction states at rest, 4h,12h, 24h, and 48h after surgery were recorded in the two groups. EPDS scores were recorded 1 day before, 2 days postoperatively, and 1 month postoperatively. Concentrations of BDNF were measured before and 2 days after surgery. Results The VAS score in resting, exercise, and contraction states in the ES group was generally better than that of the D group (P<0.05). The EPDS score of 2 days postpartum and 1 month postpartum in the ES group was lower than that in the D group (P<0.05). There was no significant difference in the concentration of BDNF after surgery between the two groups (P>0.05), and the positive patients in the ES group (EPDS>10) responded to es-ketamine (EPDS in 1 month postpartum The difference between BDNF concentrations in <10) and plasma BDNF concentrations in es-ketamine non-responders (10 postpartum EPDS>10) was statistically significant. Conclusion Esketamine can improve postpartum depression in cesarean section, reduce EPDS score, and effectively relieve postoperative pain in cesarean section, and the plasma BDNF level of patients who respond to es-ketamine is higher than that of patients who do not respond to es-ketamine.
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